Who? What? How much? When…?

Four questions and a single answer:
Personalised/Precision medicine

Article posted on: 29 August 2016

Medicine’s great challenge has always been to treat patients, not diseases.

Nowadays, and thanks to our advances in the knowledge of the genome of individuals, populations and diseases, combined with the potential of new technologies, this idea is ceasing to be a dream and starting to become a reality.

Precision Medicine is opening one of the greatest opportunities in biomedicine for humankind-some have compared this with the arrival of the man on the Moon.

Generally speaking, traditional medicine has been based on a causal, diagnostic-treatment relationship where the same diagnosis always requires the same treatment. We know, however, that there are differences between patients in the intensity with which a disease manifests itself, in the response or in the secondary effects of a treatment. We have a number of examples in which we can observe important differences between patients in effectiveness or toxicity, which further complicates the treatment regime and requires permanent monitoring.

The great advances carried out in the field of genetics/genomics and the introduction of cutting edge technology into medical practice allows us to have today a glimpse of the brilliant future of personalised medicine. Adapting clinical treatments to the genomic profile of patients will improve the efficacy of the treatment, as well as reduce the onset of secondary effects, and treatments with a low cost-to-effectiveness ratio. In spite of this, and although its cost has decreased considerably in recent years, the high cost of genomics profiling makes us think that its implementation will require a long process not lacking in difficulties, in particular for the access of innovating medical treatment for the poorest sectors of society. Even so, we believe that these advances will ultimately be unstoppable.

Within this context, myriad research groups, as well as the first firms dedicated to the commercial exploitation of specialised medicine, have proliferated. Some of these companies are selling tests to predict genetic predisposition to develop certain diseases; others have specialised in predicting the risk of cancer relapse (with other diseases accompanying it) by means of tumor gene expression, which could prevent unnecessary chemotherapy. In our country, there are Spanish biomedical firms specialising in the design and marketing of exclusive genetic clinical diagnostic products and services, based mostly on microarray and massive sequencing technologies.

Giving the right treatment at the right time

This is the precise challenge being faced by modern medicine, along with the need for self-sustainability of healthcare systems. Scientific advances are already there, what we need now is to find out how to finance and coordinate all efforts to make this new way to understand medicine a success.

This issue is to be discussed at the Genomics Summit which is part of the new HIMSS Europe World of Health IT (WoHIT) Conference & Exhibition taking place on 21–22 November 2016 in Barcelona, Spain.

Two works to which I contributed:
As a consulting expert:
As a co-author:

Jaime Del Barrio Seoane. President Asociación Salud Digital, Spain